Decoding of facial emotions, in terms of expressiveness, by schizophrenics and depressives

Development and Validation of the AIIMS Facial Toolbox for Emotion Recognition

Background

Emotional facial expression database, used in emotion regulation studies, is a special set of pictures with high social and biological relevance. We present the AIIMS Facial Toolbox for Emotion Recognition (AFTER) database. It consists of pictures of 15 adult professional artists displaying seven facial expressions-neutral, happiness, anger, sadness, disgust, fear, and surprise.

Methods

This cross-sectional study enrolled 15 volunteer students from a professional drama college in India (six males and nine females; mean age = 26.2 ± 1.93 years). They were instructed to pose with different emotional expressions in high and low intensity. A total of 240 pictures were captured in a brightly lit room against a common, light background. Each picture was validated independently by 19 mental health professionals and two professional teachers of dramatic art. Apart from recognition of emotional quality, ratings were done for each emotion on a 5-point Likert scale with respect to three dimensions-intensity, clarity, and genuineness. Results are discussed in terms of mean scores on all four parameters.

Results

The percentage hit rate for all the emotions, after exclusion of contempt, was 84.3%, with the mean kappa for emotional expression being 0.68. Mean scores on intensity, clarity, and genuineness of the emotions depicted in the pictures were high.

Conclusions

The database would be useful in the Indian context for researching facial emotion recognition. It has been validated among a group of experts and was found to have high inter-rater reliability.

Facial expression-based indicators of schizophrenia: Evidence from recent research

Impaired ability to recognize emotion in other's face (decoding) or to express emotion through the face (encoding) are considered critical in schizophrenia. The topic of research draws considerable attention since clinicians rely heavily on the patient's facial expressions for diagnosis and on the patient's ability to understand the clinician's communicative intent. While most researchers argue in favor of a generalized emotion deficit, others indicate an emotion-specific deficit in schizophrenia. An early review (Mandal et al., 1998) indicated a possible breakdown in perception-expression-experience link of emotion; later reviews (Kohler et al., 2010; Chan et al., 2010) pointed to a generalized emotion processing deficit due to perceptual deficits in schizophrenia. The present review (2010-2022) revisits this controversy with 47 published studies (37 decoding, 10 encoding) conducted on 2364 patients in 20 countries. Schizophrenia is characterized by reduced emotion processing ability, especially with negative symptoms and at an acute state of illness. It is however still unclear whether this dysfunction is independent of a generalized face perception deficit or of subjective experience of emotion in schizophrenia.

Robotic Telemedicine for Mental Health: A Multimodal Approach to Improve Human-Robot Engagement

COVID-19 has severely impacted mental health in vulnerable demographics, in particular older adults, who face unprecedented isolation. Consequences, while globally severe, are acutely pronounced in low- and middle-income countries (LMICs) confronting pronounced gaps in resources and clinician accessibility. Social robots are well-recognized for their potential to support mental health, yet user compliance (i.e., trust) demands seamless affective human-robot interactions; natural 'human-like' conversations are required in simple, inexpensive, deployable platforms. We present the design, development, and pilot testing of a multimodal robotic framework fusing verbal (contextual speech) and nonverbal (facial expressions) social cues, aimed to improve engagement in human-robot interaction and ultimately facilitate mental health telemedicine during and beyond the COVID-19 pandemic. We report the design optimization of a hybrid face robot, which combines digital facial expressions based on mathematical affect space mapping with static 3D facial features. We further introduce a contextual virtual assistant with integrated cloud-based AI coupled to the robot's facial representation of emotions, such that the robot adapts its emotional response to users' speech in real-time. Experiments with healthy participants demonstrate emotion recognition exceeding 90% for happy, tired, sad, angry, surprised and stern/disgusted robotic emotions. When separated, stern and disgusted are occasionally transposed (70%+ accuracy overall) but are easily distinguishable from other emotions. A qualitative user experience analysis indicates overall enthusiastic and engaging reception to human-robot multimodal interaction with the new framework. The robot has been modified to enable clinical telemedicine for cognitive engagement with older adults and people with dementia (PwD) in LMICs. The mechanically simple and low-cost social robot has been deployed in pilot tests to support older individuals and PwD at the Schizophrenia Research Foundation (SCARF) in Chennai, India. A procedure for deployment addressing challenges in cultural acceptance, end-user acclimatization and resource allocation is further introduced. Results indicate strong promise to stimulate human-robot psychosocial interaction through the hybrid-face robotic system. Future work is targeting deployment for telemedicine to mitigate the mental health impact of COVID-19 on older adults and PwD in both LMICs and higher income regions.

Social cognitive endophenotypes in schizophrenia: A study comparing first episode schizophrenia patients and, individuals at clinical- and familial- 'at-risk' for psychosis

Impairments in specific domains of social cognition have been suggested as possible endophenotypes for schizophrenia and clinical markers for accurate identification of 'at-risk' (AR) states. Aim of the present study was to find out whether performance on social cognition tasks will distinguish 'clinical at-risk (CAR)' and 'familial at-risk (FAR)' individuals from remitted first episode schizophrenia (FES) patients and healthy controls. Fifty in each of these four groups were included for analysis. Schizophrenia psychopathology in FES group was assessed using the Positive and Negative Syndrome Scale (PANSS). Theory of mind (ToM; first and second order (SOT and FOT), and faux pas composite (FPC)), attributional bias (AB) and social perception (SP) were assessed using the Social Cognition Rating Tool in Indian Setting (SOCRATIS). Facial emotion recognition task was used to assess emotional-expression recognition (ER). Significant differences in ToM, SP and ER between the four groups were found, even after controlling for performance on various neurocognitive tasks. ToM and SP were identified to follow an endophenotype pattern. While, both ToM and SP classified FES from healthy with large accuracy rates, SP, specifically, distinguished at-risk from disease groups. None of the social cognitive domains accurately classified familial at-risk from clinical at-risk groups. We conclude that social cognitive measures may be used as reliable endophenotype markers for schizophrenia and its sub-domains may be used for valid identification of AR individuals.

The racially diverse affective expression (RADIATE) face stimulus set

Faces are often used in psychological and neuroimaging research to assess perceptual and emotional processes. Most available stimulus sets, however, represent minimal diversity in both race and ethnicity, which may confound understanding of these processes in diverse/racially heterogeneous samples. Having a diverse stimulus set of faces and emotional expressions could mitigate these biases and may also be useful in research that specifically examines the effects of race and ethnicity on perceptual, emotional and social processes. The racially diverse affective expression (RADIATE) face stimulus set is designed to provide an open-access set of 1,721 facial expressions of Black, White, Hispanic and Asian adult models. Moreover, the diversity of this stimulus set reflects census data showing a change in demographics in the United States from a white majority to a nonwhite majority by 2020. Psychometric results are provided describing the initial validity and reliability of the stimuli based on judgments of the emotional expressions.

East Asian Young and Older Adult Perceptions of Emotional Faces From an Age- and Sex-Fair East Asian Facial Expression Database

There is increasing interest in clarifying how different face emotion expressions are perceived by people from different cultures, of different ages and sex. However, scant availability of well-controlled emotional face stimuli from non-Western populations limit the evaluation of cultural differences in face emotion perception and how this might be modulated by age and sex differences. We present a database of East Asian face expression stimuli, enacted by young and older, male and female, Taiwanese using the Facial Action Coding System (FACS). Combined with a prior database, this present database consists of 90 identities with happy, sad, angry, fearful, disgusted, surprised and neutral expressions amounting to 628 photographs. Twenty young and 24 older East Asian raters scored the photographs for intensities of multiple-dimensions of emotions and induced affect. Multivariate analyses characterized the dimensionality of perceived emotions and quantified effects of age and sex. We also applied commercial software to extract computer-based metrics of emotions in photographs. Taiwanese raters perceived happy faces as one category, sad, angry, and disgusted expressions as one category, and fearful and surprised expressions as one category. Younger females were more sensitive to face emotions than younger males. Whereas, older males showed reduced face emotion sensitivity, older female sensitivity was similar or accentuated relative to young females. Commercial software dissociated six emotions according to the FACS demonstrating that defining visual features were present. Our findings show that East Asians perceive a different dimensionality of emotions than Western-based definitions in face recognition software, regardless of age and sex. Critically, stimuli with detailed cultural norms are indispensable in interpreting neural and behavioral responses involving human facial expression processing. To this end, we add to the tools, which are available upon request, for conducting such research.

Development and validation of Indian Affective Picture Database

Since culturally salient stimuli for emotion recognition are scarce in India, we developed and validated a set of 140 coloured pictures of six basic emotions along with a neutral expression. The expressions were posed by four expressers, two males and two females, with mean age of 25.25 (SD 3.77) years. The expressions were captured from five different angles keeping the background uniform. These pictures were shown to 350 undergraduates who labelled the emotion and rated their intensity. The mean biased hit rate was 93.02 (SD 7.33) and mean unbiased hit rate was .519 (SD .015). Within subjects ANOVA revealed significant main effect of emotion (F(1, 6) = 7.598, p < .001). The t-test value (23.116, p < .001) shows that the given emotion was identified correctly by participants beyond chance factors. The mean intensity rating was 5.94 (SD .77). Overall, the results reveal that the pictures are a valid set of affective stimuli.

Emotion processing bias and age of seizure onset among epilepsy patients with depressive symptoms

The current study examined whether mood-congruent biases in emotion processing extend to epilepsy patients with depressive symptoms and the potentially moderating effects of age of seizure onset on these biases. In addition, we examined associations between depression (Beck Depression Inventory - 2nd Edition; BDI-II) and quality of life (Quality of Life in Epilepsy - 10-item questionnaire; QOLIE-10). Data from 101 epilepsy patients were analyzed, including 61 females and 40 males. Measures included the Comprehensive Affect Testing System - Abbreviated (CATS-A), from which indices of mood-congruent bias were derived. A significant interaction between BDI-II raw scores and age of seizure onset was found for mood-congruent bias scores in the facial affect modality (β=-0.24, p<.03). Beck Depression Inventory - 2nd Edition raw scores were significantly and positively correlated with quality of life (QOLIE-10; r=.69, p<.01). Results of the current study show that epilepsy patients with an early age of seizure onset may be most at risk for mood-congruent biases when experiencing depressive symptoms and that such symptoms have real-world implications for quality of life for persons living with epilepsy.

Validation of Social Cognition Rating Tools in Indian Setting (SOCRATIS): A new test-battery to assess social cognition

Social cognition is a cognitive domain that is under substantial cultural influence. There are no culturally appropriate standardized tools in India to comprehensively test social cognition. This study describes validation of tools for three social cognition constructs: theory of mind, social perception and attributional bias. Theory of mind tests included adaptations of, (a) two first order tasks [Sally-Anne and Smarties task], (b) two second order tasks [Ice cream van and Missing cookies story], (c) two metaphor-irony tasks and (d) the faux pas recognition test. Internal, Personal, and Situational Attributions Questionnaire (IPSAQ) and Social Cue Recognition Test were adapted to assess attributional bias and social perception, respectively. These tests were first modified to suit the Indian cultural context without changing the constructs to be tested. A panel of experts then rated the tests on likert scales as to (1) whether the modified tasks tested the same construct as in the original and (2) whether they were culturally appropriate. The modified tests were then administered to groups of actively symptomatic and remitted schizophrenia patients as well as healthy comparison subjects. All tests of the Social Cognition Rating Tools in Indian Setting had good content validity and known groups validity. In addition, the social cure recognition test in Indian setting had good internal consistency and concurrent validity.

Facial emotion perception in depression and bipolar disorder: a quantitative review

A considerable body of literature has reported on emotion perception deficits and the relevance of these impairments in persons with depression and bipolar disorder. Fifty-one studies published between 1981-February 2009 were examined regarding emotion perception abilities between patient and control groups, and potential methodological, demographic and clinical moderators. Studies were identified through a computerized literature search of the MEDLINE, PsychINFO, and PubMed databases. The Meta-analysis Of Observational Studies in Epidemiology (MOOSE) standard (Stroup et al., 2000) was followed in the extraction of relevant studies and data. Data on emotion perception, methodology, demographic and clinical characteristics were compiled and analyzed using Comprehensive Meta-Analysis version 2.0 (Biostat, 2005). The meta-analysis revealed a moderate deficit in emotion perception in both bipolar disorder and major depressive disorder, irrespective of task type, diagnosis, age of onset/duration of illness, sex, and hospitalization status. Several factors that moderated the observed impairment include self-reported depression, age at time of testing, and years of education. Emotion perception impairment in bipolar disorder and major depressive disorder represents a moderate and stable deficit that appears to be moderated by a limited number of demographic and clinical factors.

Negative biases and risk for depression; integrating self-report and emotion task markers

BACKGROUND

Negativity biases and their impact on reactivity to negative emotion are implicated in the mechanisms of risk for depression. The aim of this study was to determine whether self-reported negativity bias is related to objective cognitive measures of emotional reactivity.

METHODS

A previously established Web self-report measure of negativity bias was used to assess 1,080 volunteers from the Brain Resource International Database (overseen by the nonprofit BRAINnet Foundation). We identified matched subgroups of "High Risk" (n = 216) and "Low Risk" (n = 216) participants using a psychometric high-risk method, which classified High Risk as the sample's top 30% of negativity bias scores and Low Risk as the bottom 30%. These subsamples also completed the WebNeuro cognitive tasks for assessing both conscious and nonconscious reactions to facial emotions. Task performance was quantified by accuracy, reaction time, and misidentification errors.

RESULTS

The High Risk (high negativity bias) subgroup was distinguished by greater reactivity to negative emotion in both conscious and nonconscious processing. The High Risk profile was reflected in higher accuracy for sadness (nonconsciously) and disgust (consciously), and more frequent misidentification of neutral as anger (consciously).

CONCLUSIONS

These results are consistent with seminal theories that a systematic cognitive negativity bias produces a hyper-reactivity to negative emotion, which can impact nonconscious as well as conscious processing. The results provide a step toward objective markers of risk for depression that would help the community act regarding preventative programs. Replication in patient samples is warranted.

Patients with schizophrenia show increased aversion to angry faces in an associative learning task

BACKGROUND

We were interested in examining the relationship between socially relevant stimuli and decision processes in patients with schizophrenia.

METHOD

We tested patients with schizophrenia and healthy controls on a stochastically rewarded associative learning task. Participants had to determine, through trial and error, which of two faces was associated with a higher chance of reward: one face was angry, the other happy.

RESULTS

Both patients and healthy controls were able to perform the task at above-chance accuracy, and there was no significant difference in overall accuracy between the groups. Both groups also reliably preferred the happy face, such that they selected it more often than the angry face on the basis of the same amount of positive versus negative feedback. However, patients were significantly more averse to the angry face, such that they chose it less often than control participants when the reward feedback strongly supported the angry face as the best choice.

CONCLUSIONS

Patients show an increased aversion to angry faces, in a task in which they must learn to associate rewards with expressions.

Facial emotion perception in schizophrenia: a meta-analytic review

OBJECTIVES

A considerable body of literature has reported on emotion perception deficits and the relevance to clinical symptoms and social functioning in schizophrenia. Studies published between 1970-2007 were examined regarding emotion perception abilities between patient and control groups and potential methodological, demographic, and clinical moderators. DATA SOURCES AND REVIEW: Eighty-six studies were identified through a computerized literature search of the MEDLINE, PsychINFO, and PubMed databases. A quality of reporting of meta-analysis standard was followed in the extraction of relevant studies and data. Data on emotion perception, methodology, demographic and clinical characteristics, and antipsychotic medication status were compiled and analyzed using Comprehensive Meta-analysis Version 2.0 (Borenstein M, Hedges L, Higgins J and Rothstein H. Comprehensive Meta-analysis. 2. Englewood, NJ: Biostat; 2005).

RESULTS

The meta-analysis revealed a large deficit in emotion perception in schizophrenia, irrespective of task type, and several factors that moderated the observed impairment. Illness-related factors included current hospitalization and--in part--clinical symptoms and antipsychotic treatment. Demographic factors included patient age and gender in controls but not race.

CONCLUSION

Emotion perception impairment in schizophrenia represents a robust finding in schizophrenia that appears to be moderated by certain clinical and demographic factors. Future directions for research on emotion perception are discussed.

The NimStim set of facial expressions: judgments from untrained research participants

A set of face stimuli called the NimStim Set of Facial Expressions is described. The goal in creating this set was to provide facial expressions that untrained individuals, characteristic of research participants, would recognize. This set is large in number, multiracial, and available to the scientific community online. The results of psychometric evaluations of these stimuli are presented. The results lend empirical support for the validity and reliability of this set of facial expressions as determined by accurate identification of expressions and high intra-participant agreement across two testing sessions, respectively.

Brief Communication: VISUAL-FIELD SUPERIORITY AS A FUNCTION OF STIMULUS TYPE AND CONTENT: FURTHER EVIDENCE

The present study examined visual-field advantage as a function of presentation mode (unilateral, bilateral), stimulus structure (facial, lexical), and stimulus content (emotional, neutral). The experiment was conducted in a split visual-field paradigm using a JAVA-based computer program with recognition accuracy as the dependent measure. Unilaterally, rather than bilaterally, presented stimuli were significantly better recognized. Words were significantly better recognized than faces in the right visual-field; the difference was nonsignificant in the left visual-field. Emotional content elicited left visual-field and neutral content elicited right visual-field advantages.

Facial emotion perception in schizophrenia: a meta-analytic review

OBJECTIVES

A considerable body of literature has reported on emotion perception deficits and the relevance to clinical symptoms and social functioning in schizophrenia. Studies published between 1970-2007 were examined regarding emotion perception abilities between patient and control groups and potential methodological, demographic, and clinical moderators. DATA SOURCES AND REVIEW: Eighty-six studies were identified through a computerized literature search of the MEDLINE, PsychINFO, and PubMed databases. A quality of reporting of meta-analysis standard was followed in the extraction of relevant studies and data. Data on emotion perception, methodology, demographic and clinical characteristics, and antipsychotic medication status were compiled and analyzed using Comprehensive Meta-analysis Version 2.0 (Borenstein M, Hedges L, Higgins J and Rothstein H. Comprehensive Meta-analysis. 2. Englewood, NJ: Biostat; 2005).

RESULTS

The meta-analysis revealed a large deficit in emotion perception in schizophrenia, irrespective of task type, and several factors that moderated the observed impairment. Illness-related factors included current hospitalization and--in part--clinical symptoms and antipsychotic treatment. Demographic factors included patient age and gender in controls but not race.

CONCLUSION

Emotion perception impairment in schizophrenia represents a robust finding in schizophrenia that appears to be moderated by certain clinical and demographic factors. Future directions for research on emotion perception are discussed.

Emotion recognition via facial expression and affective prosody in schizophrenia: a methodological review

Disturbances in affect recognition may be one of the most pervasive and serious aspects of the schizophrenic patient's interpersonal problems. Interest in the decoding of emotional information in schizophrenia has focused on facial affect recognition with 29 experimental papers on that topic published since 1987. A smaller literature exists on the topic of recognition of affect in speech and there are at least seven studies, which have examined both face and voice perception in the same individuals with schizophrenia. This paper includes a comprehensive analysis of the schizophrenia facial affect recognition research over the past decade and the schizophrenia literature on affective prosody, and provides the first review of the schizophrenia literature on multichannel emotion recognition research. The weight of evidence would suggest that individuals with schizophrenia experience problems in the perception of emotional material; however, the specificity, extent, and nature of the deficits are unclear. Emotion recognition research in schizophrenia should be informed by the general literature on emotion recognition with serious attention paid to methodological issues.

Cross-cultural patterns in emotion recognition: highlighting design and analytical techniques

This article highlights a range of design and analytical tools for studying the cross-cultural communication of emotion using forced-choice experimental designs. American, Indian, and Japanese participants judged facial expressions from all 3 cultures. A factorial experimental design is used, balanced n x n across cultures, to separate "absolute" cultural differences from "relational" effects characterizing the relationship between the emotion expressor and perceiver. Use of a response bias correction is illustrated for the tendency to endorse particular multiple-choice categories more often than others. Treating response bias also as an opportunity to gain insight into attributional style, the authors examined similarities and differences in response patterns across cultural groups. Finally, the authors examined patterns in the errors or confusions that participants make during emotion recognition and documented strong similarity across cultures.

Detection of facial expressions of emotions in depression

Research on perceptual and attentional processes in depression has shown that depressed as opposed to nondepressed individuals do not exhibit a positive perceptual bias in multistimulus representations. In the present study a face-in-the-crowd task was applied to examine the relationship between depression and spatial detection of facial expression of positive and negative emotions. A face-in-the-crowd task was administered to 30 subjects (15 clinically stabilized depressed inpatients and 15 normal subjects) using displays of schematic faces. Depressed subjects showed no performance differences in the detection of negative faces and no differences in decision latency for the control condition (all neutral faces) compared to normal subjects. Depressed subjects, however, were significantly slower in responding to positive faces than normal subjects. Our data suggest that depressive mood is associated with a reduced spatial attention to positive facial expression and not with an abnormal spatial processing of negative facial expression. An implication is that lowered vigilance for facial expressions of joy and happiness may affect adversely interpersonal relationships in depressed subjects.

Visual-field bias in the judgment of facial expression of emotion

The left and right hemispheres of the brain are differentially related to the processing of emotions. Although there is little doubt that the right hemisphere is relatively superior for processing negative emotions, controversy exists over the hemispheric role in the processing of positive emotions. Eighty right-handed normal male participants were examined for visual-field (left-right) differences in the perception of facial expressions of emotion. Facial composite (RR, LL) and hemifacial (R, L) sets depicting emotion expressions of happiness and sadness were prepared. Pairs of such photographs were presented bilaterally for 150 ms, and participants were asked to select the photographs that looked more expressive. A left visual-field superiority (a right-hemisphere function) was found for sad facial emotion. A hemispheric advantage in the perception of happy expression was not found.

Impaired eye expression recognition in schizophrenia

Schizophrenia has been associated with abnormalities in recognising social emotions, inferring others' mental states and in gaze and visual scanning behaviours. Eye expression is known to convey considerable information in normal circumstances. Our study assessed the ability of individuals with schizophrenia to recognise simple and complex mental states from eye expressions alone. Sixteen individuals with a DSM-IV diagnosis of schizophrenia following SCAN [Schedules for Clinical Assessment in Neuropsychiatry (Wing JK, Babor T, Brugha T, Burke J, Cooper JE, Giel R et al. SCAN: schedules for clinical assessment in neuropsychiatry. Archives of General Psychiatry 1990;47:589-593).] interview and 16 healthy controls acted as participants. Expressions of 10 emotions (e.g. happy, afraid) and 10 complex mental states (e.g. thoughtful, bored), in the form of pictures of whole faces or eyes alone, were presented for recognition using a forced-choice response design. We observed impaired recognition of complex mental states in individuals with schizophrenia, from eye expressions alone (P=0.012). No differences in the recognition of basic emotions were detected. We also observed a negative correlation between illness chronicity and expression recognition performance (r=-0.65, P=0.006). The reduced ability of schizophrenia patients to recognise eye expressions of complex mental states could be interpreted as supporting a lack of "theory of mind". However, more parsimonious explanations based on impairments in basic recognition processes could also apply. An awareness of these processing abnormalities may have implications for future therapeutic strategies and our understanding of the pathophysiology of the disorder.

Effects of lesion variables and emotion type on the perception of facial emotion

The purpose of this study was to consider the effects of valence, motoric direction (i.e., approach/withdrawal), and arousal on the perception of facial emotion in patients with unilateral cortical lesions. We also examined the influence of lesion side, site, and size on emotional perception. Subjects were 30 right-hemisphere-damaged (RHD) and 30 left-hemisphere-damaged (LHD) male patients with focal lesions restricted primarily to the frontal, temporal, or parietal lobe. Patient groups were comparable on demographic and clinical neurological variables. Subjects were tested for their ability to match photographs of four facial emotional expressions: happiness, sadness, fear, and anger. Overall, RHD patients were significantly more impaired than LHD patients in perceiving facial emotion. Lesion side, but not site, was associated with motoric direction and valence dimensions. RHD patients had specific deficits relative to LHD patients in processing negative and withdrawal emotions; there were no group differences for positive/approach emotions. Lesion size was not significantly correlated with accuracy of emotional perception.

Depressed patients' perceptions of facial emotions in depressed and remitted states are associated with relapse: a longitudinal study

Within the framework of interpersonal and cognitive theories of depression, we investigated whether the perception of facial emotions was associated with subsequent relapse into depression. The 23 inpatients with major depression who remitted (65 admitted patients) were studied at admission (T0), at discharge (T1), and 6 months thereafter to assess relapse. They judged schematic faces with respect to the expression of positive and negative emotions. Six patients (26.1%) relapsed. High levels of perception of negative emotions in faces, either assessed at T0 or at T1, were associated with relapse. Moreover, subjects saw more negative emotions in depressed than in remitted state. Significant results were confined to ambiguous faces, i.e., faces expressing equal amounts of positive and negative emotions. Our data support the hypothesis that a bias toward the perception of others' facial emotions as negative is an enduring vulnerability factor to depression relapse and depressed mood amplifies this negative bias in perception.

Generality and specificity of emotion-recognition deficit in schizophrenic patients with positive and negative symptoms

Schizophrenic patients with positive and negative symptoms, as well as non-patient control subjects, were asked to recognize emotional stimuli of happy, sad, and neutral facial expressions. Dependent measures were the percentage of correct responses, and the incorrect use of an emotion category owing to false recognition. Schizophrenic patients with negative symptoms exhibited a generalized emotion-recognition deficit, and their use of emotion categories during false recognition was random. Schizophrenic patients with positive symptoms showed a deficit in their recognition of 'sad' emotion and were 'positively biased' to the category 'happy' as reflected by its most frequent usage during false recognition.

Impairments in judgment of chimeric faces by schizophrenic and affective patients

The hypothesis that schizophrenic and affective patients have differential impairments in judgment of facial emotional expressions was tested on 55 right-handed patients: 15 in each of two groups of schizophrenic patients, with positive and negative symptoms; and 10 in each of two groups of bipolar affective patients, in manic and depressive states. In addition, 37 normal control subjects were also tested. The subjects were presented with eight schematic drawings of chimeric faces (each depicting a positive emotion in a given hemiface, and a negative emotion in the other hemiface), as well as with two drawings of composite faces (each depicting either a positive or a negative emotion). Subjects judged the emotions depicted by the facial expressions, as well as their intensity. The data, analyzed by analyses of variance, showed that normals judged the chimeric expressions on the basis of the emotions depicted by the left hemifaces. This tendency was weaker among the psychiatric patients. Schizophrenics with negative symptoms judged positive expressions in the left hemifaces as depicting negative emotions, and negative expressions as depicting positive emotions. Schizophrenics with positive symptoms and manic patients judged all expressions as depicting positive emotions. Depressive patients showed a stronger tendency to judge negative expressions as depicting negative emotions than positive expressions as depicting positive emotions. No significant group differences appeared in judgment of composite faces (except for schizophrenic with negative symptoms who were more accurate in judging positive than negative expressions). Patients performances were interpreted in terms of differential dysfunctions in posterior areas of the right cerebral hemisphere which might be associated with bilateral effects of dysfunctions in anterior cerebral areas.

Right hemisphere damage impairs the ability to process emotional expressions of unusual faces

Patients with focal brain damage, right and left hemisphere damage, and nonpatient controls were asked to match photographs of emotion expressions that were depicted in unusual (line drawings, strange, and schematic) and normal (usual) representations of faces with the target emotion expressions of normal face. Nonpatient controls were significantly superior to right hemisphere damaged patients in matching photographs of emotion expressions that were depicted in line drawings of normal face and schematic face.

Hemifacial asymmetry in emotion expressions

We examined asymmetry in posed facial expression of emotions: happy and sad. Hemifacial composite photographs, left-left and right-right, were prepared, and subjects rated these for intensity of expressed emotion. Overall, left-left composites were judged to have expressed emotions relatively more intensely than the right-right composites. The significant Sex x Emotion interaction revealed that female expressors were judged as more expressive than male expressors in expressing sad facial emotion. Sex difference in expression of happy facial emotion was not significant.

Relationship between perception of facial emotions and anxiety in clinical depression: does anxiety-related perception predict persistence of depression?

Within the framework of interpersonal theories on depression, it was postulated 1) that an anxiety-related mood-congruent bias with respect to the perception of facial expressions could be demonstrated in clinically depressed patients: 2) that the perception of negative facial emotions would be associated with co-occurring anxiety levels rather than with depression, and 3) that the putative anxiety-related bias would predict the subsequent course of depression. Such relationships would support the possible causal role of negative biases for the persistence of depression. Thirty-nine depressed patients (thirty-six patients met the criteria for major depression, two had a dysthymic disorder and one patient suffered from a cyclothymic disorder) were studied. The patients judged schematic faces with respect to the emotions they express (fear, happiness, anger, sadness, disgust, surprise, rejection and invitation) at admission (T0), and after 6 (T1) and 30 (T2) weeks. Severity of depression (BDI) and anxiety (SCL-90) were assessed at these three points. We found considerable support for the first 2 hypotheses: a) The perception of negative emotions was related to anxiety but not to depression (at T0 this association was significant and at T1 and T2 tendencies were found); b) When the level of depression was controlled for, significant relationships remained (emerged) between anxiety and the perception of negative emotions at each of the three different time points; c) Anxiety and perception of negative emotions covaried within subjects when large changes in depression/anxiety were involved, i.e. after 30 weeks. This relationship disappeared when depression change was partialled out. The third hypothesis was not confirmed: The perception of negative emotions did not predict the course of depression. Although a direct relationship with depression persistence and a negative bias in the perception of interaction-relevant stimuli (i.e. facial emotions) in anxious depressed patients could not be found, the existence of such anxiety-related negative bias forms indirect evidence for the notion that this negative bias may mediate rejective attitudes of others towards depressives and consequently may contribute to an unfavorable course of depression.

Emotion-specific processing deficit in focal brain-damaged patients

Focal brain-damaged patients (left hemisphere damage, right hemisphere damage) and hospitalized general medical patients were asked to sort test photographs into target expressions of four facial emotions, happy, sad, fear and anger. In a second task, patients were asked to match neutral photographs with these target emotion expressions in a forced-choice format. Patients were also asked to rate their mood state on a two-dimensional affect grid. Right hemisphere-damaged patients were significantly inaccurate in matching the test-target expressions of facial emotions in comparison to left hemisphere-damaged or general medical patients. Analysis of error scores indicated a bias toward negative emotions by left hemisphere-damaged patients. Congruent to their mood state, left hemisphere-damaged patients also attributed "sadness" on neutral state of expression significantly more often than in right hemisphere-damaged patients.

Induction of depressed and elated mood by music influences the perception of facial emotional expressions in healthy subjects

The judgement of healthy subject rating the emotional expressions of a set of schematic drawn faces is validated (study 1) to examine the relationship between mood (depressed/elated) and judgement of emotional expressions of these faces (study 2). Study 1: 30 healthy subjects judged 12 faces with respect to the emotions they express (fear, happiness, anger, sadness, disgust, surprise, rejection and invitation). It was found that a particular face could reflect various emotions. All eight emotions were reflected in the set of faces and the emotions were consensually judged. Moreover, gender differences in judgement could be established. Study 2: In a cross-over design, 24 healthy subjects judged the faces after listening to depressing or elating music. The faces were subdivided in six 'ambiguous' faces (i.e., expressing similar amounts of positive and negative emotions) and six 'clear' faces (i.e., faces showing a preponderance of positive or negative emotions). In addition, these two types of faces were distinguished with respect to the intensity of emotions they express. 11 subjects who showed substantial differences in experienced depression after listening to the music were selected for further analysis. It was found that, when feeling more depressed, the subjects perceived more rejection/sadness in ambiguous faces (displaying less intensive emotions) and less invitation/happiness in clear faces. In addition, subjects saw more fear in clear faces that express less intensive emotions. Hence, results show a depression-related negative bias in the perception of facial displays.

Typicality range deficit in schizophrenics' recognition of emotion in faces

Severity of thought disorder in schizophrenics was assessed by a task that involved recognition of joy and shame expression, with the expressions varied for typicality of the emotion category. Accuracy, typicality rating, and reaction time were measured in schizophrenic patients who were high or low on Whitaker's Index of Schizophrenic Thinking (WIST) and in depressive and normal controls. All groups had significant variation of typicality ratings for joy (normal typicality range), but the clinical groups had smaller typicality ranges for shame recognition and higher mean typicality ratings than did normals. High WIST schizophrenics were least accurate on low typical shame expressions. Results imply that, for shame recognition, schizophrenic and depressive groups used common categorization (no typicality variation in category members) rather than resemblance categorization.

Asymmetry in emotional face: its role in intensity of expression

Normal subjects rated expressiveness of two posed facial emotions, happy and sad; the photographs were stratified in terms of intensity of expression and were prepared in composite (right-right, left-left), normal, and mirror-reversed facial orientations. The left side of the face was more expressive for intermediate intensity expressions of happiness and for least intense expressions of happiness and sadness. The right side of the face was more expressive for most intense expressions of happiness and sadness.

Exposed eye area (EEA) in the expression of various emotions

Exposed eye area (EEA) was measured in photographs of Indian adults who modeled six emotions--happiness, sadness, fear, anger, surprise, and disgust--as well as a neutral expression. The data were analyzed with a 2 x 6 (Eyes x Emotions) factorial analysis of covariance (ANCOVA). EEA for neutral expression was used as the covariate measure. The EEAs of the two eyes did not differ significantly during the expression of emotion. The EEAs for fear and surprise were significantly larger, and the EEA for disgust was significantly smaller than those for either other emotions or neutral expression.

Role of cerebral hemispheres and regions in processing hemifacial expression of emotion: evidence from brain-damage

Patients with focal brain-damage, right or left hemisphere-damage (RHD/LHD) and anterior or posterior region-damage (ARD/PRD), and normal controls (NC) were asked to match the photographs of (left-right) hemifacial expressions of emotions, positive (happy-surprise), negative-aroused (fear-anger), negative-nonaroused (sad-disgust). Findings indicated that (a) NC subjects were significantly superior to brain-damaged patients; the difference between RHD and LHD patients was nonsignificant, and (b) ARD patients were significantly inferior to PRD patients who, in turn, were significantly inferior to NC subjects, in the perceptual matching task with hemifacial affective stimuli.

Right brain damage impairs recognition of negative emotions

Patients with right or left hemisphere-damage and normal control groups were asked to judge facial emotions from photographs presented in two orientations--upright, inverted. Responses were elicited with a matching and a verbal labelling task. Normal controls were significantly superior in the judgment of facial emotions than left hemisphere-damaged patients, who in turn were significantly superior than right hemisphere-damaged patients. Negative-aroused (fear, anger) and negative-nonaroused (sadness, disgust) facial expressions were recognized with significantly greater accuracy by left hemisphere-damaged patients compared to right hemisphere-damaged patients; the group difference in performance was nonsignificant for positive (happiness, surprise) emotions.

Proximal spacing to facial affect expressions in schizophrenia

Schizophrenics (N = 40), depressives (N = 36), anxiety neurotics (N = 35), and nonpatient controls (N = 60) were asked to walk forward from a distance of 10 feet to a distance comfortable for possible interaction with facial expressions of six affects and a neutral state, depicted in life-sized images. Schizophrenics demanded significantly greater proximal space than other groups to interact with facial affect expressions, especially the nonaroused ones (happy, sad, neutral state). Multiple discriminant analysis of the "comfortable interaction distance" data revealed that schizophrenic persons may be discriminated with moderate accuracy (52.5%) from other groups.

Paralinguistic characteristics of speech in schizophrenics and depressives

Schizophrenics, depressives, patients with anxiety neurosis and normal controls were asked to comment freely for 2 min on photographs depicting seven facial emotional expressions. Schizophrenics commented for the shortest duration of time with characteristic vocalization; depressives' speech was characterized by low initiative time latency, greater duration of utterance but fewer word-counts.